Fertility preservation in girls with turner syndrome: prognostic signs of the presence of ovarian follicles.
BACKGROUND
Many girls with Turner syndrome have follicles in their ovaries at adolescence.


OBJECTIVE
Our objective was to study which girls might benefit from ovarian tissue freezing for fertility preservation.


METHODS
Clinical and laboratory parameters and ovarian follicle counts were analyzed among girls referred by 25 pediatric endocrinologists.


METHODS
Fifty-seven girls with Turner syndrome, aged 8-19.8 yr, were studied at a university hospital.


METHODS
Ovarian tissue was biopsied laparoscopically, studied for the presence of follicles, and cryopreserved. Blood samples were drawn for hormone measurements.


METHODS
Presence of follicles in the biopsied tissue related to age, signs of spontaneous puberty, karyotype, and serum concentrations of gonadotropins and anti-Müllerian hormone were assessed.


RESULTS
Ovarian biopsy was feasible in 47 of the 57 girls. In 15 of the 57 girls (26%), there were follicles in the tissue piece analyzed histologically. Six of seven girls (86%) with mosaicism, six of 22 (27%) with structural chromosomal abnormalities, and three of 28 with karyotype 45X (10.7%) had follicles. Eight of the 13 girls (62%) with spontaneous menarche had follicles, and 11 of the 19 girls (58%) who had signs of spontaneous puberty had follicles. The age group 12-16 yr had the highest proportion of girls with follicles. Normal FSH and anti-Müllerian hormone concentrations for age and pubertal stage were more frequent in girls with follicles.


CONCLUSIONS
Signs of spontaneous puberty, mosaicism, and normal hormone concentrations were positive and statistically significant but not exclusive prognostic factors as regards finding follicles.
Borgström
Birgit
B
Department of Pediatrics, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Birgit.borgstrom@ki.se
Birgit
Borgström
B
Hreinsson
Julius
J
Julius
Hreinsson
H
Rasmussen
Carsten
C
Carsten
Rasmussen
R
Sheikhi
Maryam
M
Maryam
Sheikhi
S
Fried
Gabriel
G
Gabriel
Fried
F
Keros
Victoria
V
Victoria
Keros
K
Fridström
Margareta
M
Margareta
Fridström
F
Hovatta
Outi
O
Outi
Hovatta
H
D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D002648:Child; D005260:Female; D005298:Fertility; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008279:Magnetic Resonance Imaging; D006080:Ovarian Follicle / Q000502:physiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D014424:Turner Syndrome / Q000097:blood / Q000503:physiopathology*
D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone